Financial Bid Submission Form

FINANCIAL BID SUBMISSION FORM

(To be submitted in Commercial Bid)

[The Bidder shall fill in this Form in accordance with the instructions indicated No alterations to its format shall be permitted and no substitutions shall be accepted.]

Date: [insert date (as day, month and year) of Bid Submission]

NCB No.: [insert number of bidding process]

Invitation for Bid No.: [insert No of IFB]

Alternative No.: [insert identification No if this is a Bid for an alternative]

To: [insert complete name of Purchaser]

We, the undersigned, declare that:

(a) The total price of our Bid, excluding any discounts offered in item (b) below, is: [insert the total bid price in words and figures, indicating the various amounts and the respective currencies];

(b) (b)The discounts offered and the methodology for their application are:

Discounts.If our bid is accepted, the following discounts shall apply.[Specify in detail each discount offered and the specific item of the Schedule of Requirements to which it applies.]

Methodology of Application of the Discounts.The discounts shall be applied using the following method: [Specify in detail the method that shall be used to apply the discounts];

1 c) The following commissions, gratuities, or fees have been paid or are to be paid with respect to the bidding process or execution of the Contract: [insert complete name of each Recipient, its full address, the reason for which each commission or gratuity was paid and the amount and currency of each such commission or gratuity]

Name of Recipient Address Reason Amount

(If none has been paid or is to be paid, indicate “none.”)

(d) We understand that this bid, together with your written acceptance thereof included in your notification of award, shall constitute a binding contract between us, until a formal contract is prepared and executed.

(e) We understand that you are not bound to accept the lowest evaluated bid or any other bid that you may receive.

(f) We hereby certify that we have taken steps to ensure that no person acting for us or on our behalf will engage in bribery.

(g) We undertake that, in competing for (and, if the award is made to us, in executing) the above contract, we will strictly observe the laws against fraud and corruption in force in India namely, “Prevention of Corruption Act 1988.”

2 Signed: [insert signature of person whose name and capacity are shown]

In the capacity of [insert legal capacity of person signing the Financial Bid Submission Form]

Name: [insert complete name of person signing the Financial Bid Submission Form]

Duly authorized to sign the bid for and on behalf of: [insert complete name of Bidder]

Dated on ______day of ______, ______[insert date of signing]

Note: To be completed and submitted /uploaded as a part ofCommercial Bid

3 BIDDER’S JV MEMBERS INFORMATION FORM

[The Bidder shall fill in this Form in accordance with the instructions indicated below. The following table shall be filled in for the Bidder and for each member of a Joint Venture]].

NCB No.: [insert number of bidding process]

Invitation for Bid No.: [insert No of IFB]

Alternative No.: [insert identification No if this is a Bid for an alternative]

Page ______of______pages

1. Bidder’s Name: [insert Bidder’s legal name]

2. Bidder’s JV Member’s name: [insert JV’s Member legal name]

3. Bidder’s JV Member’s country of registration: [insert JV’s Member country of registration]

4. Bidder’s JV Member’s year of registration: [insert JV’s Member year of registration]

5. Bidder’s JV Member’s legal address in country of registration: [insert JV’s Member legal address in country of registration]

6. Bidder’s JV Member’s authorized representative information Name: [insert name of JV’s Member authorized representative] Address: [insert address of JV’s Member authorized representative] Telephone/Fax numbers: [insert telephone/fax numbers of JV’s Member authorized representative] Email Address: [insert email address of JV’s Member authorized representative]

7. Attached are copies of original documents of[check the box(es) of the attached original documents]  Articles of Incorporation (or equivalent documents of constitution or association), and/orregistration documents of thelegal entity named above, in accordance with ITB 4.3.  In case of a Government-owned enterprise or institution, documents establishing legal and financial autonomy, operation in accordance with commercial law, and absence of dependent

4 status, in accordance with ITB 4.5. 2. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership. Signature of the Authorized Person …………………………………….. …………………………………….

5 Price Schedule Forms (To be submitted in Commercial Bid )

[The Bidder shall fill in these Price Schedule Forms in accordance with the instructions indicated. The list of line items in column 1 of the Price Schedules shall coincide with the List of Goods and Related Services specified by the Purchaser in the Schedule of Requirements.]

6 Section IV Bidding Forms 7

Sl. no Name of the cost component Units Unit cost Applicable Total amount (inclusive in No. (in Rs.) Tax of all taxes) (in Rs.) (inRs.) Capital Cost (Table-1) 1. Cycle 530 2. Cycle geared 20 3. Installation of Major Docking Station 12 4. Installation of Minor Docking Station 40 5. Cameras 52 6. Shifting vehicle 6 7. Control Center with Call Centre 1 8. Maintenance Center 1 9. Website + Mobile Phone App 1 10. Software 1 11. Smart Card for Payment 1 12. Registration Centre 6 13. Other Cost, if any Total

Sr Amount in Rs. Capital Cost Break-up (Table2) No. A. 80% of the capital cost will be paid during 1st year based on specific milestones. B. 20% of the Capital Cost will be paid as an yearly annuity basis over a period of next 5 years beginning from the 2nd year. Total Capital Cost (A+B)

7 Month wise cost of Operation and Maintenance (in Rs.) Sl. Name of the cost 1st year 1st Year No. component (6 months 2nd 3rd 4th 6th (1st 5th year after Year Year Year Year 6 months) installation) Operational and Maintenance Cost (Table-3) 1. Marketing Cost

2. Operation and Maintenance Cost including a. maintenance cost of cycles NA* b. maintenance cost of - Procuremen docking station t and c. maintenance cost of Installation Control Centre & Phase Maintenance Centre d. Operating Cost of Shifting Vehicle. 3. Manpower Cost 4. Miscellaneous expenses 5. Operator’s Margin 6. Other Cost, if any

*NA-Not Applicable